The Role of Environmental Controls in Managing Asthma in Lower-Income Urban Communities

Laura Conrad, Matthew S. Perzanowski

Research output: Contribution to journalReview article

Abstract

Children living in lower-income urban communities are at much greater risk of developing asthma, going to the emergency department for an asthma attack and being hospitalized for asthma than children living in upper- and middle-income communities. For many asthmatic children living in urban communities, especially those with greater morbidity, the allergic pathway is important in the etiology of the disease. The stages of developing allergic disease can be divided into the onset of allergic sensitization, development of allergic disease and subsequent exacerbations, and it is useful to consider the relevance of interventions at each of these stages. Indoor allergens and environmental exposures are a major contributor to allergic disease, particularly among lower socioeconomic status, urban, minority communities. These exposures include allergens, environmental tobacco smoke, combustion by-products, and mold, all of which can play an important role in asthma progression as well as morbidity. These exposures are often not found in isolation and thus these concomitant exposures need to be considered when conducting environmental interventions. There have been numerous studies looking at both primary and tertiary prevention strategies and the impact on allergic sensitization and asthma with varied results. While the outcomes of these studies have been mixed, what has emerged is the need for tertiary interventions to be targeted to the individual and to reduce all relevant exposures to which an asthmatic child is exposed and sensitized. In addition, effective intervention strategies must also consider other social determinants of asthma morbidity impacting low socioeconomic, urban communities.

Original languageEnglish (US)
Pages (from-to)391-402
Number of pages12
JournalClinical Reviews in Allergy and Immunology
Volume57
Issue number3
DOIs
StatePublished - Dec 1 2019
Externally publishedYes

Keywords

  • Allergens
  • Combustion by-products
  • Environmental tobacco smoke
  • Interventions
  • Mold

ASJC Scopus subject areas

  • Immunology and Allergy

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